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Contract 47627
CITY SECfMAW. - COWRACT NO. EASEMENT ENCROACHMENT LICENSE AGREEMENT Caninercial THIS AGREEMENT is made and entered into by and between THE CITY OF FORT WORTH, a home rule municipal corporation of Tarrant County, Texas ("City"), acting by and through its duly authorized City Manager, its duly designated Assistant City Manager or Planning and Development Director, and WINCO FOODS, LLC, a Delaware limited liability company ("Licensee"), owner of the real property located at 8968 Tehama Ridge Parkway, Fort Worth, Texas ("Property"). RECITALS WHEREAS, Licensee is the owner of certain real property situated in the City of Fort Worth, Tarrant County, Texas, more particularly described in the attached Legal Description of the Property; and WHEREAS, the City has a water and sewer easement (the "Easement") in the Property as shown on the map attached to this Agreement as Exhibit "A" and incorporated herein for all purposes; and WHEREAS, Licensee desires to construct/place and maintain certain improvements which will encroach onto the Easement; and WHEREAS, City will allow the encroachment under the terms and conditions as set forth in this Agreement to accommodate the needs of the Licensee. NOW,THEREFORE, the City and Licensee agree as follows: AGREEMENT 1. City, in consideration of the payment by the Licensee of the fee set out below and, covenants and agreements hereinafter contained, to be kept and performed by Licensee, hereby grants permission to Licensee to encroach upon and occupy a portion of the City's Easement for the purpose of the construction and operation of a stormwater conveyance system, fire hydrant assembly and sewer service line (the "Encroachment") as described in and at the location shown on Exhibit "A" but only to the extent shown thereon. Upon completion of the Encroachment, Licensee agrees to be responsible for maintaining the Encroachment within and above the Easement. Licensee shall not expand or otherwise cause the Encroachment to further infringe in or on City's Easement beyond what is specifically described in the Exhibit(s) attached hereto. OFFICIAL RECORD CITY SECRETARY 2015 Easement Encroachment Agreement-Commercial FT WORTHY Tx a�(le I of 1 2. All construction, maintenance and operation in connection with such Encroachment, use and occupancy shall be performed in strict compliance with this Agreement and the City's Charter, Ordinances and Codes and in accordance with the directions of the Director of the Transportation and Public Works or the Director of the City's Water Department, or his or her duly authorized representative. Licensee shall submit all plans and specifications to the applicable Director or his or her duly authorized representative prior to the construction of the Encroachment. Licensee shall not commence construction of the Encroachment until receiving written approval by the Director, but such approval shall not relieve Licensee of responsibility and liability for concept, design and computation in the preparation of such plans and specifications. 3. Upon prior written notice to Licensee, except in the case of an emergency, Licensee agrees that City may enter and utilize the referenced areas at any time for the purpose of installing, repairing, replacing, or maintaining improvements to its public facilities or utilities necessary for the health, safety and welfare of the public or for any other public purpose. City shall bear no responsibility or liability for any damage or disruption or other adverse consequences resulting from the Encroachment installed by Licensee, but City will make reasonable efforts to minimize such damage. In the event that any installation, reinstallation, relocation or repair of any existing or future utility or improvements owned by, constructed by or on behalf of the public or at public expense is made more costly by virtue of the construction, maintenance or existence of the Encroachment and use, Licensee shall pay to City an additional amount equal to such additional cost as reasonably determined by the Director of Transportation and Public Works or the Director of the Water Department, or said Director's duly authorized representative. 4. Licensee agrees to pay to City at the time this Agreement is requested an application fee of$325.00 in order to defray all costs of inspection and supervision which City has incurred or will incur as a result of the construction, maintenance, inspection or management of the encroachments and uses provided for by this Agreement. 2015 Easement Encroachment Agreement -Commercial Pa,,e 2 of 12 5. The term of this Agreement shall be for 30 years, commencing on the date this Agreement is executed by City. However, this Agreement shall terminate upon Licensee's non-compliance with any of the terms of this Agreement. City shall notify Licensee in writing of the non-compliance, and if not cured within 30 days, this Agreement shall be deemed terminated, unless such non-compliance is not susceptible to cure within 30 days, in which case this Agreement shall be deemed terminated in the event that Licensee fails to commence and take such steps as are necessary to remedy the non-compliance with 30 days after written notice specifying the same, or having so commenced, thereafter fails to proceed diligently and with continuity to remedy same. 6. It is further understood and agreed between the parties hereto that the Easement to be used and encroached upon as described herein, is held by City as trustee for the public; that City exercises such powers over the Easement as have been delegated to it by the Constitution of the State of Texas or by the Texas Legislature; and that City cannot contract away its duty and its legislative power to control the Easement for the use and benefit of the public. It is accordingly agreed that if the governing body of City may at any time during the term hereof determine in its sole discretion to use or cause or permit the Easement to be used for any other public purpose, that does not preclude the use of the Encroachment on the Property, including but not being limited to underground, surface or overhead communication, drainage, sanitary sewerage, transmission of natural gas or electricity, or any other public purpose, whether presently contemplated or not, that the parties agree to negotiate in good faith in order to accommodate the Encroachment and the public purpose. 7. LICENSEE COVENANTS AND AGREES TO INDEMNIFY, AND DOES HEREBY INDEMNIFY, HOLD HARMLESS AND DEFEND CITY, ITS OFFICERS, AGENTS, SERVANTS, EMPLOYEES, AND ELECTED OFFICIALS FROM AND AGAINST ANY AND ALL CLAIMS OR SUITS FOR PROPERTY DAMAGE OR LOSS AND/OR PERSONAL INJURY, INCLUDING DEATH, TO ANY AND ALL PERSONS, OF WHATSOEVER KIND OR CHARACTER, ARISING OUT OF OR IN CONNECTION WITH, THE CONSTRUCTION, MAINTENANCE, OCCUPANCY, USE, EXISTENCE OR LOCATION OF THE ENCROACHMENT AND USES GRANTED HEREUNDER, WHETHER OR NOT CAUSED, IN WHOLE OR IN PART, BY THE NEGLIGENCE OF OFFICERS, AGENTS, SERVANTS, EMPLOYEES, CONTRACTORS, SUBCONTRACTORS, LICENSEES, ELECTED OFFICIALS, OR INVITEES OF THE CITY; AND LICENSEE HEREBY ASSUMES ALL LIABILITY AND RESPONSIBILITY FOR SUCH CLAIMS OR SUITS. LICENSEE SHALL LIKEWISE ASSUME ALL LIABILITY AND RESPONSIBILITY AND SHALL INDEMNIFY CITY FOR 2015 Easement Encroachment Agreement-Commercial Page 3 of 12 ANY AND ALL INJURY OR DAMAGE TO CITY PROPERTY ARISING OUT OF OR IN CONNECTION WITH THE ENCROACHMENTS AND ANY AND ALL ACTS OR OMISSIONS OF LICENSEE, ITS OFFICERS, AGENTS, SERVANTS, EMPLOYEES, CONTRACTORS, SUBCONTRACTORS, LICENSEES, OR INVITEES. 8. While this Agreement is in effect, Licensee agrees to furnish City with a Certificate of Insurance naming City as certificate holder, as proof that it has secured and paid for a policy of public liability insurance covering all public risks related to the proposed use and occupancy of public property as located and described in Exhibit"A". The amounts of such insurance shall be not less than $1,000,000 Commercial General Liability with the understanding and agreement by Licensee that such insurance amounts may be revised upward at City's option and that Licensee shall so revise such amounts immediately following notice to Licensee of such requirement. Such insurance policy shall not be canceled or amended without at least 30 days prior written notice to the Building Official of the City of Fort Worth. A copy of such Certificate of Insurance is attached as Exhibit `B" and incorporated herein for all purposes. Licensee agrees to submit a similar Certificate of Insurance annually to City on the anniversary date of the execution of this Agreement Licensee agrees, binds and obligates itself, its successors and assigns, to maintain and keep in force such public liability insurance at all times during the term of this Agreement and until the removal of the Encroachment and the cleaning and restoration of the Easement. All insurance coverage required herein shall include coverage of all Licensees' contractors and subcontractors. 9. Licensee agrees to deposit with City when this Agreement is executed a sufficient sum of money to be used to pay necessary fees to record this Agreement in the Real Property Records of Tarrant County, Texas. After being recorded, the original shall be returned to the City Secretary of the City of Fort Worth. 10. Licensee agrees to comply fully with all applicable federal, state and local laws, statutes, ordinances, codes or regulations in connection with the construction, operation and maintenance of the Encroachment and uses. 2015 Easement Encroachment Agreement -Commercial Page 4 of 12 11. Licensee agrees to pay promptly when due all fees, taxes or rentals provided for by this Agreement or by any federal, state or local statute, law or regulation. 12. Licensee covenants and agrees that it shall operate hereunder as an independent contractor as to all rights and privileges granted hereunder and not as an officer, agent, servant or employee of City, and Licensee shall have exclusive control of and the exclusive right to control the details of its operations, and all persons performing same, and shall be solely responsible for the acts and omissions of its officers, agents, servants, employees, contractors, subcontractors, licensees and invitees. The doctrine of respondeat superior shall not apply as between City and Licensee, its officers, agents, servants, employees, contractors and subcontractors, and nothing herein shall be construed as creating a partnership or joint enterprise between City and Licensee. 13. Licensee agrees and acknowledges that this Agreement is solely for the purpose of permitting Licensee to construct, maintain and locate the Encroachment over or within the Easement and is not a conveyance of any right, title or interest in or to the Easement nor is it meant to convey any right to use or occupy property in which a third party may have an interest. Licensee agrees that it will obtain all necessary permissions before occupying such property. 14. In any action brought by the City for the enforcement of the obligations of the Licensee, City shall be entitled to recover interest and reasonable attorney's fees. 15. The parties agree that the duties and obligation contained Sections 3 and 4 shall survive the termination of this Agreement. 16. Licensee covenants and agrees that it will not assign all or any of its rights, privileges or duties under this Agreement without the written approval of City, and any attempted assignment without such written approval shall be void. In the event Licensee conveys the Property, Licensee may assign all of its rights and obligations under this Agreement to the new owner of the Property, and Licensee shall be deemed released from its duties and obligations hereunder upon City's approval in writing of such assignment, which approval shall not be unreasonably conditioned or withheld. Foreclosure by a secured lender of Licensee or assignment to a secured lender by Licensee in the event of 2015 Easement Encroachment Agreement-Commercial Page 5 of 12 default or otherwise shall not require City approval provided that said lender notifies City in writing within 60 days of such foreclosure or assignment and assumes all of Licensees' rights and obligations hereunder. However, no change of ownership due to foreclosure or assignment to any secured lender of Licensee shall be effective as to City unless and until written notice of such foreclosure or assignment is provided to City. 17. Any cause of action for breach of this Agreement shall be brought in Tarrant County, Texas. This Agreement shall be governed by the laws of the State of Texas. 18. This Agreement shall be binding upon the parties hereto, their successors and assigns. SIGNATURES APPEAR ON FOLLOWING PAGE] 2015 Easement Encroachment Agreement-Commercial Page 6 of 12 THIS AGREEMENT may be executed in multiple counterparts, each of which shall be considered an original, but all of which shall constitute one instrument. City Licensee: CITY OF FORT ORTH WINCO FOODS, LLC By: By t U � Randle 4wood Name: Director Title: G Planning and Develo ment Date: 2016 ATTEST: Approved As To Form and Legality r C�c TWO City Se et ®� FOP j Assistant Ci y Attorney v s 0 J �`°00000uoeo AS OFFICIAL RECORD CITY SECRETARY FT.WORTH,TX 2015 Easement Encroachment Agreement-Commercial Page 7 of 12 STATE OF TEXAS § COUNTY OF TARRANT § i i` j This i ent was acknowledged before me on , 2016 by all Harwood, Director of the Planning and Development Department of the City of Fort Worth, on behalf the City of Fort Worth. CASSANDRA F. FOREMAN Notary Public, State of Texas =_�kY Pueos Notary PUWC,State of Texas N My Commission Exp{res ?iTFF•�":' Aptil 26, 2017 O h/lllll � After Recording Return to: Cassandra Foreman Planning and Development Department 1000 Throckmorton Street Fort Worth TX, 76102 2015 Easement Encroachment Agreement-Commercial Page 8 of t2 STATE OF IDAHO ) ss. COUNTY OF ADA ) On this day of 1�(A� 0 bef ire me, the undersigned notary public for s 'd state, personally appeare (Y `Z g, -known to me to be the _ of WINCO FOODS, LLC, the person whose name is subscribed to the foregoing instrument, and acknowledged to me that he executed the same on behalf of said limited liability company. IN WITNESS WHEREOF, I have hereunto et my hand and affixed my official seal the day and year in this certificate first above tt ANDREA C. DEGUZMAN (VOTARY PUBLIC rea C. Deguzman STATE OF IDAHO NOTARY PUBLIC in an o t State of Idaho, residing at Boise My commission expires May 15, 2019 2015 Easement Encroachment Agreement-Commercial Page 9 of 12 LEGAL DESCRIPTION OF THE PROPERTY TRACT 1: (Fee Simple) Beinq all of that tract of land situated in the City of Fort Worth, Tarrant County, Texas and beinq out of the William 1,1cCowan Survey, Abstract No. 999, and beinq a part of a portion of Lot 1, Block U, of the Correction Plat of THE PRESIQIt9, an addition to the City of Fort Worth, as recorded in Cabinet A, Panes 131177-13078, of the flap Records, Tarrant County, Texas(1`1.R.T.C.T.), said tract being more particularly described as follows: BEGINNING at a point for corner beinq the ;northeasterly corner of said Lot 1, same being the northwesterly corner of Lot 2, Block G of said addition, said corner also beinq in file southeasterly right- of-way t-ofway line of Presidio Vista Drive; THENCE in a southeasterly direction, along the cornmon line bemeen said Lots i and the following courses and distances: South 1131'59'47" East, a distance of 15.71'to a point for corner; South 1111'29'49" East, a distance of 249.83' to a point for corner; South 116°26'28" East, a distance of 121.118' to a point for corner; South U8°19'36" East, a distance of 149.93` to a point for corner, South 18"49'55" East, a distance of 67,06'to a point for corner; South 31`111748" East, a distance of 67.33'to a point for corner; South 49`05'05" East, a distance of 56.54' to a point for corner; THENCE over and across said Lot IR, tlae following courses and distances: [Legal description continues on the following page.] 2015 Easement Encroachment Agreement-Commercial Page 10 of 12 South 911'00'011" West, a distance of 537.25' to a 112`' iron rod with a yellow plastic cap stamped "RPLS 5686" set (herein after referred to as a rapped iron rod set); North 111101w'ou"West, a distance of 077.29'to a capped iron rod set; South 90'00'00"West, a distance of 254.36' to a capped iron rrod set ill the easterly r-rght-of-way line of Tehama Ridqe Parkway, same beinq the westerly line of said Lot 1R; THENCE North 15034'111" West, alonq said easterly right-of-way line of Tehama Ridqe Parkway, same beinq the westerly line of said Lot 1, a distance of 142.112' to a capped iron rod set at the beginning of a curve to the rigl}t,having a radius of 880.00', a central anc;ie of 15"34`111", and a chord which beats, North 0714705"West, a chord distance of 238.39'; Thence along said curve to the right, in a northwesterly direction, an arc length of 239.13' to an "X" set in concrete at the end of said curve; THENCE North 111101111`1111" West, continuinq along said easterly riclht-of-way line of Tehama Ridqe Parkway, a distance of 110.1u1' to in :'X" set in concrete at the southwesterly end of a corner-clip at the intersection of said Tehama Ridqe Parkway and Presidio Vista Drive; THENCE North 45111111°0u0" East, alonq said corner clip, a distance of 14,14`to an "X" set in concrete in the southerly right-of-way line of said Presidio Vista Drive; THENCE North 90"00'(10" East, alonq said southerly right-of-way line of Presidio Vista Drive, sime beinq the northerly line of said Lot 1, a distance of 333.50' to an "X" set in concrete at the betlinninq of a curve to the left, having a radius of 4911.1111', a central angle of 21322'118°', and a chord which bears, North 79018'56" East, a chord distance of 151.69'; Thence along said curve to the left, in a northeasterly direction, an arc length of 132.75' to an "X" set in concrete at the endof said curve; THENCE North 531137'54" East, continuinq along said southeasterly right-of-way line of Presidio Vista Drive, a distance of 269.40' to the POINT OF BEGINNING and containing 111.171 acres of land, more or less. 2015 Easement Encroachment A-reement-Commercial Page I 1 of 12 EXHIBIT "A" Map of Encroachment and Easement 2015 Easement Encroachment Agreement-Commercial Page 12 of 12 .r d . I PRESIDIO VISTA DR _ I --- --- I I I I o --. III I f' I II I Q 0 I1 30 SANITARY "' iL 11 SEWER EASEMENT II " Q 30' PERMANENT WATER I ��- I LINE EASEMENT I W 25' PRIVATE IQ I DRAINAGE EASEMENT LI— L W 1 WINCO m FOODS �. BUILDING 1 c . \ \ \ I}}!I \ \ I u 4 \ \\ \ i II \ II \ I I II H 0 150 300 SCALE IN FEET EXHIBIT "A" PAGE 1 OF 3 0 FORT WORTH TX, WINCO FOODS SCJ ALLIANCESITE PLAN EXHIBIT CONSULTING SERmVICES"CES CO BNO TALLON IANE M,SUITE P.3603521461,3W 352 00,LACEY, 1509 98516 PART OF LOT 1, BLOCK D THE PRESIDIO CAB.A, PG, 1307 M.R.T.C.T. SCIALL'.ANCE.COM PROPOSED STORM STRUCTURE B1 10 CURB INLET 8" S,N14R SE ER 0 0 I I I I 30' SANITARY SEWER BASEMENT VOL. 16382, PG 256, R.T.C.T. I I I 30' PERMANENT WATE LINE EASEMENT INST. NO. D205367 42, D.R.T.C.T. FLOOD PLAIN EASEMENT FG. Pli 13077, M.R.T.C.T. 1 W 25' PRIVATE DRAINAGE EASEMENT CAB. A, PG. R -v 13077, M.R.T.C.T. WINCO FOODS a 1 _ .....RCB',:. m BUILDING — .5._x5.—— s � I 0O I PROPOSED FIRE HYDRANT nn AND 6" FIRE LINE 1 a cl- ® I o ul1 Q J I Ica .f ul y I \ PROPOSED STORM I I 0 50 100 STRUCTURE "Cl" E I SCALE IN FEET w I G. I (EXHIBIT "A" PAGE 2 OF 3 FORT WORTH TX, WINCO FOODS SCJ ALLIANCESCIES CONSULTIUTILITY LOCATION EXHIBIT NG SERVICES °"°T""°" "`"321°`m°''"`°"''"" � "'"G'°"' 16 PART OF LOT 1, BLOCK D THE PRESIDIO CAB.A, PG: 13077, M.R.T.C.T. D:360.35JAL1 F 366352-1509 SC3ALLJi!.:CE.iOM 692- _ _ - __ -692 PROPOSED GROUND EXISTING GROUND .6" FIRE LINE �- 688-- IE:686.00 - -688 18" MIN. 684- --684 - SD LINE B1 B1 SD LINE Cl 186 LF OF 24" RCP 10' CURB INLIET 680- 204 LF OF 30" RCP @ 0.96% STA:1+85.63, -f80 C1 @ 0.50% EXISTING 5'x5' RCB RIM:689.12 4 GRATE INLET STORMWATER LINE IE OUT:683.87 24" - STA:2+04.46 RIM:687.54 676- IE OUT:682.83 30" 8 SEWER -676 LINE H 0 50 100 SCALE 1N FEET EXHIBIT "A" PAGE 3 OF 3 FORT WORTH TX, WINCO FOODS SCJ ALLIANCE PROFILE EXHIBIT CONSULTING SERVICES 8770 TALLON IANC NC,6UITE 200,36U 152 d51uINGTON 98516 PART OF LOT 1, BLOCK D THE PRESIDIO CAB.A, PG. 13077, M.R.T.C.T. 0'1E NE,S flT i,16G-Y,WAST. CIAiI.IAtiCI.CON. Client#: 1073 WINCOFOO ACORD. CERTIFICATE OF LIABILITY INSURANCE DATD/YYYY) 2/225/2051201 s THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(les)must be endorsed.If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAME T Helen Irwin Moreton 8r Company-Idaho PHONE 208 321-9300 FA No): 208-321-0101 AIC,No,Ext P.O.Box 191030 E-MAIL hirwin@moreton.com Boise,ID 83719 INSURER(3)AFFORDING COVERAGE NAIL iK 208 321-9300 Travelers Property Casual Co. 25674 INSURER A: P Y INSURED INSURER B:Colony Insurance Company 39993 WinCo Foods,LLC INSURER C WinCo Holdings,Inc. INSURER 0 PO Box 5756 Boise, ID 83705-0756 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE NSR WVD POLICY NUMBER ADDLSUBR POLICY EFF POLICY EXP LIMITS A GENERAL LIABILITY EXGL213K4037TIL15 511412015 05/14/2016 EACH �OCCURRENCE $750000 X COMMERCIAL GENERAL LIABILITY PREMISES Ea occTu".. $50,000 CLAIMS-MADE M OCCUR MED EXP(Any one person) $ X $250,000 S.I.R. PERSONAL&ADV INJURY $750,000 GENERAL AGGREGATE $5,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $.3,000,000 PRO-P X POLICY LOC $ RO- A AUTOMOBILE LIABILITY CAP213K4049TIL15 5/1412015 051141201 COMBINED SINGLE LIMIT Ea accident 2.000,000 IX ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS HIRED AUTOS X NON-OWNED PROPERTYDAMAGE $ AUTOS Per accident $ B X UMBRELLA LIAR X OCCUR AR6460712 D511412015 05/1412016 EACH OCCURRENCE $9,000,000 EXCESS LIAR CLAIMS-MADE AGGREGATE $9,000,000 DEO RETENTION$0 $ WORKERS COMPENSATION WC STATU- I OTH- AND EMPLOYERS'LIABILITY Y/N TORY LIMITS FIR ANY PROPRIETORfPARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? ❑ N I A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ It yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space Is required) Re: Easement Encroachment License Agreement CERTIFICATE HOLDER CANCELLATION Lilt of Fort Worth SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Planning&Development Dept. ACCORDANCE WITH THE POLICY PROVISIONS. 1000 Throckmorton Street Fort Worth,TX 76102 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #S792226/M709519 HELIR